7 Descovy Side Effects: What to Expect With PrEP

Walking out of the pharmacy with a new medication for HIV can feel overwhelming. You may have already had to solve some insurance roadblocks to access the medication. And, now that you have it in hand, you may find yourself skimming the label for possible side effects.

It can be comforting to keep in mind that many HIV medications are well tolerated. And while certain side effects are possible, you don’t always have to just “deal with them.” Applying some simple tips and tricks can go a long way in making your medication experience more positive.

Here, we’ll review some common Descovy (emtricitabine / tenofovir alafenamide) side effects when taken for HIV prevention — also known as PrEP, or preexposure prophylaxis — and what you can do to manage them.

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Descovy side effects at a glance

Descovy is a combination tablet that contains emtricitabine and tenofovir alafenamide (TAF). It’s generally well tolerated, meaning that most people don’t have a hard time taking it long term. In a clinical trial looking at Descovy for PrEP, only 1% of participants stopped taking Descovy because of side effects.

The most common Descovy side effects are:

• Diarrhea

• Nausea

• Headache

• Tiredness or fatigue

• Stomach pain or discomfort

Less common but potentially serious side effects include:

• Hepatitis B exacerbation (when treatment is stopped)

• New or worsening kidney problems

• Lactic acidosis

• Overactive immune system

Below, we dive into seven of Descovy’s most notable side effects.

Good to know: When used for HIV treatment (not prevention), Descovy’s side effects may look slightly different. Descovy is combined with another medication when it’s used for this purpose. So any side effects you experience may be from Descovy, the other medication, or both.

1. Diarrhea

About 5% of people report experiencing diarrhea after they start taking Descovy. This side effect is most likely to occur when you first start taking the medication or after a dosage change. It usually gets better as your body gets used to the medication, though.

While you’re waiting for your body to adjust, there are some things you can do to manage your symptoms, including drinking clear fluids (like water and broth). If diarrhea continues to be an issue after a few days, you can talk to your healthcare provider about trying an over-the-counter (OTC) antidiarrheal medication for relief.

If your diarrhea doesn’t go away within a few weeks, talk to your provider. They may want to explore other HIV medication options for you. Or they might consider prescribing you Mytesi (crofelemer), a treatment specifically for diarrhea caused by HIV medications. 

If you’re experiencing diarrhea along with flu-like symptoms, your healthcare provider may want to run another HIV test. These are possible early symptoms of an HIV infection.

2. Nausea

Nausea, upset stomach, and stomach pain are relatively common digestion-related side effects of Descovy. But they’re typically short lived.

While you can take Descovy with or without food, many people find that taking it with food can help address these side effects. If you’re taking Descovy at the same time as other medications, just make sure that they can also be taken with food.

You might be wondering what exactly “with food” means. Regarding whether it’s better to take Descovy with a full meal or a light snack, there isn’t an answer that applies to everyone. It will depend on your body and how it responds. You might have to try a few different meal sizes to see what offers the best symptom relief.

A solid first approach is to take Descovy with plain, starchy foods. For instance, following the BRAT diet (bananas, rice, apples, toast) and eating other bland foods — such as crackers and plain pasta — can temporarily relieve stomach discomfort. Avoiding spicy and greasy foods, which can trigger digestion issues, is also helpful.

3.  Fatigue

Tiredness or fatigue can sometimes occur with Descovy. If this happens to you, try scheduling your daily Descovy dose around bedtime. Taking the medication close to bedtime allows many people to sleep off these side effects.

If taking Descovy close to bedtime isn’t an option, there are some other general strategies you can try. Getting more sleep — or even taking a 15 to 30 minute nap in the middle of the day — is a great starting point. Some people also find that light exercise and getting outside more often helps boost their energy throughout the day.

4. Headache

People taking Descovy occasionally report experiencing headaches. Similar to managing fatigue, some people find that taking Descovy close to bedtime can help manage headaches.

If you're not able to sleep through Descovy-related headaches, you can try managing them with OTC pain medications, such acetaminophen (Tylenol). But check with your pharmacist about which OTC options are safe for you to try, since these medications come with their own side effects.

5. New or worsening kidney problems

TAF, one of the active ingredients in Descovy, can potentially cause new or worsening kidney problems. This is more common among people who also take other medications that can harm the kidneys.

Proactive management is key to avoiding kidney stress. As part of this, your healthcare provider and pharmacist will want to check your medication list for possible interactions, so make sure it’s up to date with all of the medications and supplements you take. This includes OTC nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve), which are occasionally linked to kidney harm.

Your provider will also order lab tests before you start taking Descovy to check how well your kidneys are working. They’ll continue to monitor your kidney health as long as you’re taking the medication. If your lab tests show a significant change, your provider may prescribe you a different medication. One option could be Apretude (cabotegravir), a long-acting injectable that hasn’t been linked to kidney problems in the same way.

Good to know: TAF is similar to the HIV medication tenofovir disoproxil fumarate (TDF). TDF is one of the active ingredients in Truvada, the other oral option for PrEP. TAF is newer than TDF, and it tends to be safer for the kidneys.

6. Lactic acidosis

Both of Descovy’s active ingredients have been linked to lactic acidosis — a rare but serious side effect. Lactic acidosis happens when there’s too much lactic acid in the bloodstream.

Contact your healthcare provider right away if you experience symptoms of lactic acidosis, such as:

• Sudden and severe fatigue

• Unexpected muscle pain

• Shortness of breath

• Stomach pain with nausea and vomiting

• Cold or blue hands and feet

• Fast heartbeat 

If you develop lactic acidosis, your provider will likely want you to stop taking Descovy and switch to another medication. But don’t stop taking Descovy before speaking with them first.

7. Hepatitis B exacerbations

As a general rule, you should always talk to your healthcare provider before you stop taking a routine medication. This is especially true for Descovy.

Some people with a history of hepatitis B — a virus that attacks the liver cells and can cause liver problems — have experienced flare-ups after they stopped taking Descovy. Despite being rare, Descovy carries a boxed warning (the FDA’s most serious type of medication warning) for this side effect.

Contact your provider if you notice any new or worsening hepatitis B flare symptoms, such as:

• Nausea

• Stomach pain

• Loss of appetite

• Yellowing of the skin or eyes (jaundice)

• Dark urine

If you switch to another HIV medication or stop taking Descovy for another reason, your provider will monitor you for a few months for symptoms of a hepatitis B flare.

When should I contact my healthcare provider about Descovy side effects?

Many Descovy side effects are typically mild and short lived, gradually going away after time. But if you experience mild side effects that linger for a few weeks to a month, make sure to mention them to your healthcare provider. They can offer management tips.

And always make sure to listen to your body. If something feels urgent, it probably is. Contact your healthcare provider right away if you experience any bothersome side effects that affect your ability to take Descovy as prescribed. You should also contact your provider if you think you’re experiencing symptoms of a serious side effect, such as liver or kidney problems. They may want to switch you to another medication.

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Written by:

Hope Chang, PharmD, AAHIVP

Hope Chang is a freelance writer and content reviewer for GoodRx. She attended Howard University College of Pharmacy in Washington, D.C. and completed post-graduate residency training at the University of California, Davis Medical Center.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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